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Hematology Training Is Suboptimal for APPs

Advanced practice providers (APPs) may have limited subspecialty training options for hematology, and postgraduate fellowships focused on education in both malignant and nonmalignant hematologic disorders appear to be lacking for APPs. Yi L. Hwa, DNP, of the division of hematology at the Mayo Clinic in Rochester, MN, discussed the findings of a research team’s web-based needs assessment survey that found significant gaps in subspecialty hematology training for APPs at the ASH Annual Meeting on December 1, 2018.

Researchers distributed a survey via surveyhero.com to 68 APPs currently working on hematology and blood and marrow transplant (BMT) teams at three Mayo Clinic sites (Rochester, MN; Scottsdale, AZ; and Jacksonville, FL). The survey included questions on hematology-specific training and responses indicated participants’ perceptions about their readiness to practice in hematology and identified learning and training needs.

Forty-nine people (72%) completed the survey, including 34 nurse practitioners and 15 physician assistants. More than half of respondents (57%) were new APP graduates when hired, and 35% had no prior work experience in hematology or BMT. All APPs had a master’s or higher degree, including 31% with a doctorate.

Many APPs (n = 39; 80%) said less than 5% of their curriculum focused on hematology. A majority (92%) reported that the level of subspecialty training did not adequately prepare them with full confidence for practice. Most APPs (n = 44; 90%) believed subspecialty training could help them become more competent providers for this patient population.

Almost all APPs (n = 47; 96%) agreed that confidence and knowledge in their practice positively impacted job satisfaction, and 84% said that structured hematology training would encourage them to remain in hematology.

Respondents identified the following as the most important areas of education:

Variety of malignant and benign hematologic disorders, as well as hematopathology

Bone marrow transplant

Palliative care

Transfusion medicine

Infectious disease

Pharmacology related to hematology

The top three effective learning strategies respondents selected were active learning from direct patient care, cased-based teaching, and educational experience during hospital rounds.